Rodríguez Maya B, Rodríguez Goncer I, Diego Hernández C
Servicio de Medicina Interna, Hospital Universitario de Móstoles, Móstoles, Madrid, España.
Servicio de Medicina Interna, Hospital Universitario de Móstoles, Móstoles, Madrid, España.
Hipertens Riesgo Vasc. 2016 Apr-Jun;33(2):69-73. doi: 10.1016/j.hipert.2015.12.003. Epub 2016 Feb 8.
We report a case of a 37 year-old man with a long history of hypertension under treatment, who was admitted at our institution with intense fatigue and weakness of lower limbs. The laboratory results at Emergency Department showed severe hypokalemia. A study of secondary hypertension was carried out. With the initial suspicion of primary hyperaldosteronism, complete blood test was done including plasma renine activity, which was completely suppressed, and plasma aldosterone concentration, which resulted normal. Likewise, an abdomen CT was performed and revealed a left adrenal mass consistent of suprarrenal adenoma. Therefore, a salt loading suppression test was done with subsequent measure of plasmatic renine activity, which was still suppressed, plasma aldosterone concentration, that persisted normal, and a 24-h urinary aldosterone excretion rate, which was clearly high, supporting the suspected diagnosis. After the adrenalectomy, the patient remained asymptomatic with normal blood pressure without treatment and with normal serum potassium levels.
我们报告一例37岁男性患者，有长期高血压病史且一直在接受治疗，因严重疲劳和下肢无力入住我院。急诊科的实验室检查结果显示严重低钾血症。对继发性高血压进行了检查。最初怀疑为原发性醛固酮增多症，进行了全血细胞检查，包括血浆肾素活性，结果完全被抑制，血浆醛固酮浓度结果正常。同样，进行了腹部CT检查，发现左肾上腺肿块，符合肾上腺腺瘤。因此，进行了盐负荷抑制试验，随后测定血浆肾素活性，其仍被抑制，血浆醛固酮浓度持续正常，24小时尿醛固酮排泄率明显升高，支持疑似诊断。肾上腺切除术后，患者无症状，血压正常，无需治疗，血清钾水平正常。
